February 2018 page 11d
Surgery: Auditory System
Question: Auditory procedures, such as placement of tympanostomy tubes (69433, 69436), are performed using microscopic visualization. Is it appropriate to report code 69990 separately for these procedures even though the equipment listed in the code descriptor of 69990 is for microsurgery? These auditory procedures do not involve microsurgery.
Answer: No, auditory procedures for placement of tympanostomy tubes, as described by codes 69433 and 69436, are overwhelmingly performed using the operating microscope. It affords magnification, illumination, and depth perception not available with an otoscope. Clinically, the use of the operating microscope is considered...
Note: The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.
Article Overview
This article explains a coding question in the auditory system surgery section of CPT® Assistant and discusses when microscopic visualization is considered part of tympanostomy tube procedures versus separately reportable services. It is useful for coders working with ENT/auditory procedures, especially those reviewing CPT® guidance on microscope use, tympanostomy claims, and related ancillary service reporting.
Why This Topic Matters
It helps coders interpret CPT® guidance for a common pediatric and ENT procedure area and avoid inappropriate separate reporting of ancillary microscope services.
Article Sections
Question
Presents a coding question about auditory surgery procedures, microscopic visualization, and whether an ancillary service may be reported separately.
Answer
Provides CPT® Assistant guidance on the reporting relationship between tympanostomy tube placement and a microscope-related service in the context of auditory procedures.
What You Will Learn
The article’s focus within CPT® Assistant surgery guidance for the auditory system.
How the article frames a question about microscopic visualization in tympanostomy-related procedures.
The general topic of separate reporting for an ancillary microscope-related service in auditory surgery.
The scope of guidance provided for ENT coding review and claim preparation.
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